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Mo(II) and W(II) compounds, Mo(η3-allyl)(CO)2(Tri-MEDA)Br (1), Mo(η3-allyl)(CO)2(TMEDA)Br (2), W(η3-allyl)(CO)2(Tri-MEDA)Br (3), and W(η3-allyl)(CO)2(TMEDA)Br (4) (Tri-MEDA = N,N,N'-trimethylethylenediamine), were synthesized and characterized. The molecular structures of 1 and 3 were nearly identical with a pseudo-octahedral geometry except for the different Mo and W metal centers. The thermogravimetric analysis of 1 and 3 showed approximately 53 and 64% residues at 550 °C, respectively, which were significantly higher than the values for the expected materials. However, 1 and 3 sublimed at 100 °C under 0.40 Torr and 120 °C under 0.50 Torr, respectively, confirming that they were volatile. For 1 and 3, the temperatures at a vapor pressure of 1 Torr and enthalpies of vaporization (ΔHvap) were 168.78 °C and 143.8 kJ mol-1, and 167.48 °C and 148.5 kJ mol-1, respectively. The tungsten compound (3) exhibited good durability for 5 weeks under a thermal stability test at a sublimation temperature of 120 °C.
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To substitute corrosive halogen ligands, we designed and synthesized novel tungsten complexes containing amido ligands, W(DMEDA)3 (1) and W(DEEDA)3 (2) (DMEDA = N,N'-dimethylethylenediamido; DEEDA = N,N'-diethylethylenediamido). Complexes 1 and 2 were characterized by 1H NMR, 13C NMR, FT-IR, and elemental analysis. The pseudo-octahedral molecular structure of 1 was confirmed by single-crystal X-ray crystallography. The thermal properties of 1 and 2 were analyzed by thermogravimetric analysis (TGA), which confirmed that the precursors were volatile and exhibited adequate thermal stability. Additionally, the WS2 deposition test was performed using 1 in thermal chemical vapor deposition (thermal CVD). Further analysis of the surface of the thin films was conducted using Raman spectroscopy, scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS).
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Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases in patients with vitiligo and quantify their associations compared with those in healthy controls. A comprehensive search of MEDLINE and EMBASE from the inception to June 2022 was conducted. Observational studies on prevalent diseases in patients with vitiligo compared with those in healthy controls were included, whereas studies limited to pediatrics or providing only laboratory results were excluded. A total of 78 studies were eligible for analyses. Patients with vitiligo showed higher risks of having comorbid autoimmune and connective tissue diseases, including alopecia areata (OR = 2.63, 95% confidence interval [CI] = 2.50â2.78), discoid lupus erythematosus (OR = 2.54, 95% CI = 1.74â3.72), Sjogren's syndrome (OR = 2.50, 95% CI = 1.98â3.16), myasthenia gravis (OR = 2.30, 95% CI = 1.74â3.02), systemic lupus erythematosus (OR = 1.96, 95% CI = 1.52â2.52), and rheumatoid arthritis (OR = 1.82, 95% CI = 1.55â2.15). Thyroid diseases, diabetes mellitus, metabolic syndrome, sensorineural hypoacusis, and ophthalmic abnormalities were also more prevalent in patients with vitiligo. In conclusion, vitiligo is associated with various systemic diseases. Physicians should evaluate and manage potential comorbid conditions in patients with vitiligo.
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Doenças Autoimunes , Lúpus Eritematoso Sistêmico , Síndrome de Sjogren , Doenças da Glândula Tireoide , Vitiligo , Humanos , Criança , Vitiligo/epidemiologia , Comorbidade , Síndrome de Sjogren/complicações , Síndrome de Sjogren/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Doenças Autoimunes/epidemiologiaRESUMO
This study examined the effectiveness of the Happy Mother mobile app developed for self-management of postpartum depression, based on cognitive behavioural therapy. A randomized controlled trial, with a pre- and a post-test design, was conducted in South Korea. Effectiveness was analysed using repeated measures ANOVA and Wilcoxon Signed Rank Test. We confirmed that the experimental group performed significantly more health promoting behaviours than the control group (F = 5.15, p = 0.007). However, there was no significant difference in postpartum depression, knowledge of depression, maladaptive beliefs, social support, sleep quality, and stress-coping behaviours between the two groups. The experimental group's mood score increased by 1.79 ± 2.51 points, resulting in significant differences before and after the intervention (Z = -2.81, p = 0.005). The quality of sleep score in the experimental group increased by 1.48 ± 1.70 points and was also significantly different after the intervention (Z = -3.23, p = 0.001). The activity practice rate of the experimental group significantly increased by 30.27 ± 29.27% after using the app (Z = -2.81, p = 0.005). We found the app to be effective in promoting mothers' health behaviour and improving their depressive mood.
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OBJECTIVE: This study was conducted to provide basic data for preparing a disaster nursing education program. It examined the degree of nursing students' disaster awareness, disaster preparedness, willingness to participate in disaster response, and disaster nursing competency, aiming to determine the relationship between these attributes. METHODS: This was a descriptive research study. The participants were 163 nursing students. The data collected from the participants were analyzed via descriptive statistics and Pearson's correlation coefficients. RESULTS: Disaster awareness showed a positive correlation with a willingness to participate in a disaster response. Further, disaster preparedness and willingness to participate in a disaster response showed a positive correlation with disaster nursing capacity. Disaster awareness did not show a significant correlation with disaster preparedness and disaster nursing competency. Last, disaster preparedness did not show a significant correlation with willingness to participate in a disaster response. CONCLUSIONS: It is necessary to improve nursing students' disaster awareness, disaster preparation, disaster response participation willingness, and disaster nursing competency. It is imperative to develop disaster nursing education programs to strengthen students' capabilities in a comprehensive manner.
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Planejamento em Desastres , Desastres , Educação em Enfermagem , Estudantes de Enfermagem , HumanosRESUMO
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant morbidity and mortality worldwide. Despite a successful vaccination programme, the emergence of mutated variants that can escape current levels of immunity mean infections continue. Herein, we report the development of CT-P63, a broad-spectrum neutralizing monoclonal antibody. In vitro studies demonstrated potent neutralizing activity against the most prevalent variants, including Delta and the BA.1 and BA.2 sub-lineages of Omicron. In a transgenic mouse model, prophylactic CT-P63 significantly reduced wild-type viral titres in the respiratory tract and CT-P63 treatment proved efficacious against infection with Beta, Delta, and Omicron variants of SARS-CoV-2 with no detectable infectious virus in the lungs of treated animals. A randomized, double-blind, parallel-group, placebo-controlled, Phase I, single ascending dose study in healthy volunteers (NCT05017168) confirmed the safety, tolerability, and pharmacokinetics of CT-P63. Twenty-four participants were randomized and received the planned dose of CT-P63 or placebo. The safety and tolerability of CT-P63 were evaluated as primary objectives. Eight participants (33.3%) experienced a treatment-emergent adverse event (TEAE), including one grade ≥3 (blood creatine phosphokinase increased). There were no deaths, treatment-emergent serious adverse events, TEAEs of special interest, or TEAEs leading to study drug discontinuation in the CT-P63 groups. Serum CT-P63 concentrations rapidly peaked before declining in a biphasic manner and systemic exposure was dose proportional. Overall, CT-P63 was clinically safe and showed broad-spectrum neutralizing activity against SARS-CoV-2 variants in vitro and in vivo.
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COVID-19 , SARS-CoV-2 , Animais , Anticorpos Monoclonais/uso terapêutico , Anticorpos Neutralizantes , Anticorpos Antivirais , Anticorpos Amplamente Neutralizantes , Creatina Quinase , Humanos , Camundongos , Glicoproteína da Espícula de CoronavírusRESUMO
PURPOSE: This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers. METHODS: An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method. RESULTS: Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = -.18, p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were 'feeling a lack of confidence in one's suicide counselling skills', 'feeling of the limits of one's ability to cope with a suicide crisis','feeling regret for not being able to help the clients', 'being over-empathetic to the clients', 'Not being able to understand the clients because the subjects (nurses) opposes committing suicide', and 'thinking that the suicidal thoughts of suicide attempters do not improve'. CONCLUSION: To reduce burnout of nurses' suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.
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Saúde Mental , Prevenção do Suicídio , Suicídio , Atitude do Pessoal de Saúde , Esgotamento Psicológico , Humanos , Ideação Suicida , Suicídio/psicologiaRESUMO
Sarcoidosis is a systemic granulomatous disease that affects a variety of organs. Although the etiology has not been fully understood, it is thought that diverse genetic and environmental factors interact with the immune system to develop granulomas. The incidence and death rate of sarcoidosis vary according to race. This study was conducted to identify the epidemiology of sarcoidosis in Korea and reveal its association with comorbid diseases such as diabetes mellitus, hypertension, and dyslipidemia in a population-based database. We retrospectively analyzed Korean National Health Insurance claims data between 2006 and 2017. The average annual incidence from 2006 to 2017 was 0.82/100 000 person-years and the all-cause death rate in sarcoidosis patients was 9.25/1000 cases. The incidence of sarcoidosis was higher in patients with diabetes mellitus, hypertension, and dyslipidemia than patients without those underlying diseases. Sarcoidosis patients with diabetes mellitus and hypertension showed an increased death rate after adjusting the confounding factors (hazard ratio [95% confidence interval], 1.66 [1.23-2.23] and 1.73 [1.29-2.31] respectively), however, patients with dyslipidemia showed a low death rate (HR = 0.64 [0.46-0.88]). In conclusion, we found that sarcoidosis is associated with diabetes mellitus, hypertension, and dyslipidemia and that diabetes mellitus and hypertension increase the risk of death in sarcoidosis patients. Extra caution is needed in sarcoidosis patients who already have these metabolic diseases.
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Diabetes Mellitus , Dislipidemias , Hipertensão , Sarcoidose , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Granuloma , Humanos , Hipertensão/epidemiologia , Incidência , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Sarcoidose/epidemiologiaRESUMO
This study identified the effects of an integrated diabetes self-management program using smartphone application (app), based on the Information-Motivation-Behavioral skills (IMB) model. A randomized comparison, using a pre-and post-test design, was conducted with 32 participants in the experimental group and 36 in the control group. The integrated diabetes self-management program consisted of face-to-face educational sessions, a diabetes self-management smartphone app, and phone counseling. In the experimental group, diabetes self-management knowledge (Z=-2.70, p=.007), social motivation (Z=-1.97, p=.048), and behavior (t=3.22, p=.002) improved, with their hemoglobin A1c (Z=-4.83, p<.001) decreasing compared to the control group. At the post-test, the experimental group's fasting blood sugar level (t=2.79, p=.009), total calorie intake (t=3.94, p=.001), carbohydrate intake (t=5.69, p<.001), and fat intake (t=2.54, p=.021) decreased compared to the pre-test. An integrated diabetes self-management program using smartphone app, based on the IMB model, should be utilized as a nursing intervention.
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Diabetes Mellitus Tipo 2 , Diabetes Mellitus , Aplicativos Móveis , Autogestão , Diabetes Mellitus/terapia , Diabetes Mellitus Tipo 2/terapia , Hemoglobinas Glicadas/análise , Humanos , SmartphoneRESUMO
We developed and tested the effectiveness of an algorithm to prevent medical device-related pressure injuries in intensive care unit patients. It was developed in four stages: literature review and analysis of medical records; preliminary algorithm development; validation of the preliminary algorithm by experts in two rounds; and practical feasibility verification of the revised algorithm by 109 intensive care unit nurses. To verify the algorithm's effectiveness, we compared the incidence of medical device-related pressure injuries between 324 patients without algorithm application (control group) and 312 patients with algorithm application (experimental group). The outcomes were skin inspection of the medical device attachment, pressure injury evaluation, and implementation of pressure injury-preventive nursing care, based on the medical device type. The incidence rates were 1.46 per 100 devices (control group) and 1.19 per 100 devices (experimental group). Since there was no homogeneity in the previous score of the Braden scale in the experimental and control groups, the results regarding the incidence of pressure damage after applying the algorithm should be interpreted with care. Applying this algorithm was a safe intervention that helped prevent medical device-related pressure injuries in this population.
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Úlcera por Pressão , Algoritmos , Humanos , Incidência , Unidades de Terapia Intensiva , Úlcera por Pressão/epidemiologia , Úlcera por Pressão/etiologia , Úlcera por Pressão/prevenção & controle , Fatores de RiscoRESUMO
Little is known about the comorbidities in actinic keratosis patients. To evaluate the association of actinic keratosis with certain malignancies. All patients with actinic keratosis (n = 61,438) and age- and sex-matched control subjects (n = 307,190) at a 5:1 ratio were enrolled using data from the Korean National Health Insurance Service between the years 2007 and 2014. In subjects with actinic keratosis, overall cancer incidence was higher than that for controls after income level, habitat, diabetes, hypertension, and dyslipidemia were adjusted (Hazard Ratio [HR] = 1.43 [95% confidence interval 1.38-1.47]). The positive association of specific cancers were observed in the following order: skin cancer (HR = 3.43 [2.47-4.75]), oral cavity and pharyngeal cancer (HR = 1.99 [1.57-2.52]), lymphoma (HR = 1.59 [1.28-1.96]), leukemia (HR = 1.35 [1.03-1.77]), prostate cancer (HR = 1.35 [1.21-1.51]), renal cancer (HR = 1.29 [1.02-1.63]), liver cancer (HR = 1.21 [1.09-1.35]), thyroid cancer (HR = 1.20 [1.05-1.38]), and gastric cancer (HR = 1.13 [1.03-1.23]). Although further research on pathologic mechanism is needed, the implications of a positive correlation between actinic keratosis and internal organ malignancies has great significance.
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Ceratose Actínica/complicações , Ceratose Actínica/epidemiologia , Neoplasias/epidemiologia , Neoplasias/etiologia , Adulto , Idoso , Estudos de Casos e Controles , Comorbidade , Suscetibilidade a Doenças , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de RiscoRESUMO
Post-exposure prophylaxis (PEP) is highly effective in preventing disease progression of rabies when used in timely and appropriate manner. The key treatment for PEP is infiltration of rabies immune globulin (RIG) into lesion site after bite exposure, besides wound care and vaccination. Unfortunately, however, RIG is expensive and its supply is limited. Currently, several anti-rabies virus monoclonal antibody (mAb) products are under development as alternatives to RIG, and two recently received regulatory approval in India. In this study, fully human mAbs that recognize different rabies virus glycoprotein conformational antigenic site (II and III) were created from peripheral blood mononuclear cells of heathy vaccinated subjects. These mAbs neutralized a diverse range of lyssavirus types. As at least two anti-rabies virus mAbs are recommended for use in human PEP to ensure broad coverage against diverse lyssaviruses and to minimize possible escape variants, two most potent mAbs, NP-19-9 and 11B6, were selected to be used as cocktail treatment. These two mAbs were broadly reactive to different types of lyssaviruses isolates, and were shown to have no interference with each other. These results suggest that NP-19-9 and 11B6 are potent candidates to be used for PEP, suggesting further studies involving clinical studies in human.
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Anticorpos Monoclonais/administração & dosagem , Profilaxia Pós-Exposição/métodos , Vírus da Raiva/imunologia , Raiva/prevenção & controle , Animais , Anticorpos Monoclonais/imunologia , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/administração & dosagem , Anticorpos Antivirais/imunologia , Antígenos Virais/imunologia , Modelos Animais de Doenças , Combinação de Medicamentos , Mapeamento de Epitopos , Humanos , Índia , Mesocricetus , Camundongos , Biblioteca de Peptídeos , Raiva/virologiaRESUMO
The SARS-CoV-2 variant is rapidly spreading across the world and causes to resurge infections. We previously reported that CT-P59 presented its in vivo potency against Beta variants, despite its reduced activity in cell experiments. Yet, it remains uncertain to exert the antiviral effect of CT-P59 on Gamma, Delta and its associated variants (L452R). To tackle this question, we carried out cell tests and animal studies. CT-P59 showed neutralization against Gamma, Delta, Epsilon, and Kappa variants in cells, with reduced susceptibility. The mouse challenge experiments with Gamma and Delta variants substantiated in vivo potency of CT-P59 showing symptom remission and virus abrogation in the respiratory tract. Collectively, cell and animal studies showed that CT-P59 is effective against Gamma and Delta variants infection, hinting that CT-P59 has therapeutic potential for patients infected with Gamma, Delta and its associated variants.
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Anticorpos Monoclonais Humanizados/farmacologia , Anticorpos Neutralizantes/farmacologia , Tratamento Farmacológico da COVID-19 , Modelos Animais de Doenças , Imunoglobulina G/farmacologia , SARS-CoV-2/efeitos dos fármacos , Animais , Antivirais/farmacologia , Peso Corporal/efeitos dos fármacos , COVID-19/virologia , Feminino , Humanos , Camundongos Transgênicos , SARS-CoV-2/genética , SARS-CoV-2/fisiologia , Análise de SobrevidaRESUMO
Mesenchymal stem cells (MSCs) are accessible, abundantly available, and capable of regenerating; they have the potential to be developed as therapeutic agents for diseases. However, concerns remain in their further application. In this study, we developed a SMall cell+Ultra Potent+Scale UP cell (SMUP-Cell) platform to improve whole-cell processing, including manufacturing bioreactors and xeno-free solutions for commercialization. To confirm the superiority of SMUP-Cell improvements, we demonstrated that a molecule secreted by SMUP-Cells is capable of polarizing inflammatory macrophages (M1) into their anti-inflammatory phenotype (M2) at the site of injury in a pain-associated osteoarthritis (OA) model. Lipopolysaccharide-stimulated macrophages co-cultured with SMUP-Cells expressed low levels of M1-phenotype markers (CD11b, tumor necrosis factor-α, interleukin-1α, and interleukin-6), but high levels of M2 markers (CD163 and arginase-1). To identify the paracrine action underlying the anti-inflammatory effect of SMUP-Cells, we employed a cytokine array and detected increased levels of pentraxin-related protein-3 (PTX-3). Additionally, PTX-3 mRNA silencing was applied to confirm PTX-3 function. PTX-3 silencing in SMUP-Cells significantly decreased their therapeutic effects against monosodium iodoacetate (MIA)-induced OA. Thus, PTX-3 expression in injected SMUP-Cells, applied as a therapeutic strategy, reduced pain in an OA model.
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Proteína C-Reativa/metabolismo , Macrófagos/imunologia , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/citologia , Osteoartrite/terapia , Osteócitos/citologia , Dor/prevenção & controle , Componente Amiloide P Sérico/metabolismo , Animais , Citocinas/metabolismo , Modelos Animais de Doenças , Inflamação/etiologia , Inflamação/metabolismo , Inflamação/patologia , Inflamação/terapia , Injeções Intra-Articulares , Ácido Iodoacético/toxicidade , Ativação de Macrófagos/imunologia , Masculino , Osteoartrite/induzido quimicamente , Osteoartrite/metabolismo , Osteoartrite/patologia , Dor/etiologia , Dor/metabolismo , Dor/patologia , Ratos , Ratos Sprague-DawleyRESUMO
Development of drug-delivery systems that allow simultaneous in vivo imaging has gained much interest. We report a novel strategy to encapsulate metal nanoparticles (NPs) within alginate gel for in vivo imaging. The cell lysate of recombinant Escherichia coli strain, expressing Arabidopsis thaliana phytochelatin synthase and Pseudomonas putida metallothionein genes, was encapsulated within the alginate gel. Incubation of alginate gel with metal ion precursors followed by UV irradiation resulted in the synthesis of high concentrations of metal NPs, such as Au, Ag, CdSe, and EuSe NPs, within the gel. The alginate gel with metal NPs was used as a drug-delivery system by further co-encapsulating doxorubicin and rifampicin, the release of which was made to be pH-dependent. This system can be conveniently and safely used for in vitro and in vivo bioimaging, enabled by the metal NPs formed within the gel matrix without using toxic reducing reagents or surfactants.
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Alginatos/química , Portadores de Fármacos/química , Corantes Fluorescentes/química , Géis/química , Nanopartículas Metálicas/química , Aminoaciltransferases/genética , Aminoaciltransferases/metabolismo , Animais , Antineoplásicos/química , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Arabidopsis/enzimologia , Doxorrubicina/química , Doxorrubicina/farmacologia , Liberação Controlada de Fármacos , Escherichia coli/genética , Células Hep G2 , Humanos , Masculino , Metalotioneína/genética , Metalotioneína/metabolismo , Metais/química , Camundongos Nus , Pseudomonas putida/enzimologia , Rifampina/química , Rifampina/farmacologiaRESUMO
Postpartum depression is the most common mood disorder that occurs after childbirth, rendering it a significant public health problem. Information and communication technologies hold tremendous promise for expanding the reach of quality mental healthcare and closing the treatment gap for depression. In particular, given that mobile applications are inexpensive and provide information systematically, they are suitable as a method of health management that does not require visiting a medical center. The purposes of this study were to document the process of developing a mobile application for the self-management of postpartum depression and to share usability test results. The mobile application "Happy Mother" was developed based on the first five of seven stages in the mobile application development lifecycle model. Components of cognitive behavioral therapy were adopted to guide content development for "Happy Mother." The usability of the completed mobile application was tested in the following three steps: it increased awareness of mood, promoted self-management, and implemented specific methods a mother can use in her daily life to improve mood, including modifications made based on the results of the usability test.
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Depressão Pós-Parto , Aplicativos Móveis , Autogestão , Terapia Cognitivo-Comportamental , Depressão Pós-Parto/terapia , Feminino , Humanos , MãesRESUMO
Vaccines and therapeutics are urgently needed for the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we screen human monoclonal antibodies (mAb) targeting the receptor binding domain (RBD) of the viral spike protein via antibody library constructed from peripheral blood mononuclear cells of a convalescent patient. The CT-P59 mAb potently neutralizes SARS-CoV-2 isolates including the D614G variant without antibody-dependent enhancement effect. Complex crystal structure of CT-P59 Fab/RBD shows that CT-P59 blocks interaction regions of RBD for angiotensin converting enzyme 2 (ACE2) receptor with an orientation that is notably different from previously reported RBD-targeting mAbs. Furthermore, therapeutic effects of CT-P59 are evaluated in three animal models (ferret, hamster, and rhesus monkey), demonstrating a substantial reduction in viral titer along with alleviation of clinical symptoms. Therefore, CT-P59 may be a promising therapeutic candidate for COVID-19.
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Anticorpos Neutralizantes/farmacologia , Tratamento Farmacológico da COVID-19 , Ligação Proteica/efeitos dos fármacos , SARS-CoV-2/efeitos dos fármacos , Glicoproteína da Espícula de Coronavírus/efeitos dos fármacos , Enzima de Conversão de Angiotensina 2/química , Animais , Anticorpos Monoclonais/imunologia , Anticorpos Neutralizantes/química , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Chlorocebus aethiops , Modelos Animais de Doenças , Feminino , Furões , Humanos , Leucócitos Mononucleares , Macaca mulatta , Masculino , Mesocricetus , Modelos Moleculares , Conformação Proteica , Glicoproteína da Espícula de Coronavírus/química , Células VeroRESUMO
BACKGROUND: Organ transplantation is the most effective treatment for patients with end-stage organ failure. It has been actively carried out all over the world. Recently, eHealth interventions have been applied to organ transplant patients. This systematic review and meta-analysis aimed to evaluate the effects of eHealth interventions for improving medication adherence in organ transplant patients as compared to usual or conventional care alone. METHODS: We searched MEDLINE via PubMed, Excerpta Media dataBASE (EMBASE), the Cochrane Register Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and six domestic Korean databases to identify randomized controlled trials (RCTs) published up to April 17, 2020. Two reviewers independently selected relevant studies and extracted data. The quality and bias of the identified studies were assessed. To estimate the effect size, a meta-analysis of the studies was performed using the Cochrane Collaboration software Review Manager 5.3. PRISMA guidelines were followed. When statistical heterogeneity was greater than 80%, narrative synthesis was performed. RESULTS: Of the 1,847 articles identified, seven RCTs with a total of 759 participants met the inclusion criteria. The risk of bias assessment showed that the blinding of participants and personnel was high. In six studies, medication adherence (effect size = -0.18-1.30) and knowledge scores were not significantly different between those receiving eHealth interventions and the controls. CONCLUSIONS: Our findings suggest that eHealth interventions were similar to standard care or advanced care for improving medication adherence, and they faired equally well for improving medication knowledge. Therefore, eHealth interventions can be used for medication adherence of organ transplant patients. More research is needed to provide well-designed eHealth intervention to improve the medication adherence and knowledge of organ transplant patients. PROTOCOL REGISTRATION NUMBER: CRD42017067145 16/05/2017.